Inter Press Service - November 22, 2004
Diego Cevallos

The fact that Martin and so many others like him leave no statistical trace represents an enormous obstacle in efforts to fight diseases, according to the World Health Organisation (WHO), a specialised UN agency. Of the 192 UN member countries, only 66 provide reliable mortality data.

"He just kept getting weaker and weaker, and there was nothing we could do about it, we just had to watch as he died little by little," recalled Candelaria Cepeda, who lived next door to Martin's family in Chiapas, one of the poorest states in the country.

Cepeda, an indigenous Mexican who has lived in Mexico City since 1995, said that Martin is buried somewhere "in a little grave in the jungle," but neither his birth nor his death were recorded in official registers.

This is not at all unusual, added Cepeda, who is now employed in the capital as a domestic worker. Her own birth wasn't registered by her parents until she was seven years old. "If I had died before then, the government would never have known that I was born."

The failure of so many countries to accurately register deaths is one of the most challenging problems facing the international medical community, according to WHO assistant director-general Tim Evans.

Only 14 of the 35 countries of the Americas offer reliable death statistics, while only four out of the 46 nations in Africa are able to provide data of this kind, he said.

Accurate records of the number of deaths in each country and their causes would significantly improve the potential for progress in fighting certain health problems, he added.

What did little Martin die of in Chiapas? No one can say for sure. Perhaps from malnutrition, an acute infection, or Chagas' disease, an illness spread by insects that attacks the heart and digestive system. In Mexico, it is mainly limited to the impoverished state of Chiapas.

Failing to determine and record the numbers and causes of death makes the work of health care systems even more difficult, Evans stressed.

The WHO official was in Mexico City to attend the WHO Ministerial Summit on Health Research and a meeting of the Global Forum on Health Research, which both took place from Nov. 16-20 and were attended by 30 health ministers from the region and some 700 research specialists from 76 countries.

At both meetings, the participating scientists, government officials and drug company representatives pledged to work harder, better and in closer coordination to promote medical research aimed at solving the most pressing health problems in the world's poor countries.

Ever rising amounts of money are spent around the world on medical research, but most of it is aimed at developing drugs and diagnostic tests that have little relevance to the needs of low- and middle-income countries.

Moreover, the drugs that could be used to treat medical emergencies in many countries are almost never available, as is the case in Chiapas. To make matters even worse, there is only one health worker for every 1000 inhabitants in this poor Mexican state, when the minimum recommended by the WHO is 2.5.

According to WHO statistics, 65 percent of the 1.1 billion people living in India do not have access to essential medicines. In Africa, the proportion is 47 percent, while in Latin America, it is 22 percent.

In terms of medical personnel, the situation is not much better. In Africa, there are 0.8 health workers (nurses and doctors) for every 1000 inhabitants. In Latin America, eastern Europe and some Asian nations, the ratio ranges between 2.5 and four per 1000.

On the other hand, in the industrialised countries of the Organisation for Economic Cooperation and Development (OECD), there are between 10 and 15 health workers for every 1000 inhabitants.

In Mexico, the participants in the two meetings promised to work towards lessening the inequities in the area of health care.

They also stated their commitment to lowering under-five mortality by two-thirds, reducing the maternal mortality rate by three-quarters, and curbing the spread of HIV/AIDS and other major diseases, particularly in the poorest countries.

These are health-care targets established in the Millennium Development Goals, adopted by the international community in 2000 as a framework for reducing poverty, hunger and inequality by striving to reach quantifiable objectives by the year 2015.

But there are some who doubt that the participants in the meetings will keep the promises they have made and genuinely contribute to attaining these goals.

Lanny Smith of the People's Health Movement, a coalition of grassroots organisations, called the meetings in Mexico City a failure.

In his view, no concrete and objectively measurable proposals were made, nor were the world's pharmaceutical companies called upon to concentrate more on the health care needs of the developing countries and less on the interests of the wealthy developed world.

Global spending on health research grew by roughly seven billion dollars a year between 1998 and 2001 and has now reached over 105.9 billion dollars annually, with the world's industrialised nations accounting for 96 percent of the total, according to the Global Forum for Health Research, based in Geneva.

The international relief organisation Doctors Without Borders has reported that only one percent of the new drugs created between 1975 and 1999 fight tropical diseases, which are a leading cause of death in the developing world.

But in Mexico City, the pharmaceutical company spokespeople attending the meetings denied that their primary interest is working for the industrialised countries.

Gill Samuels, the senior director of science policy and scientific affairs at Pfizer, said that the drugs needed to treat the illnesses of the world's poorest people already exist, but what is lacking is the means of getting these drugs to them.

"If the cure for AIDS were a glass of clean water, many people would not have access to it, because their countries don't have the necessary infrastructure," she stated, after denying that the transnational pharmaceutical laboratories are to blame for the world's health problems.

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